Effect of high-frequency alternating current transcutaneous stimulation over muscle strength: a controlled pilot study

Diego Serrano-Muñoz, Juan Avendaño-Coy, Cristina Simón-Martínez, Julian Taylor, Julio Gómez-Soriano, Diego Serrano-Muñoz, Juan Avendaño-Coy, Cristina Simón-Martínez, Julian Taylor, Julio Gómez-Soriano

Abstract

Background: High-frequency alternating currents of greater than 1 kHz applied on peripheral nerves has been used in animal studies to produce a motor nerve block. It has been evidenced that frequencies higher than 5 kHz are necessary to produce a complete peripheral nerve block in primates, whose nerve thickness is more similar to humans. The aim of the study was to determine the effect on muscle strength after the application of a high-frequency stimulation at 5 and 10 kHz compared to sham stimulation in healthy volunteers.

Findings: Transcutaneous stimulation at 5 kHz, 10 kHz and sham stimulation were applied to eleven healthy volunteers over the ulnar and median nerves for 20 min. Maximal handgrip strength was measured before, during, immediately after the intervention, and 10 min after the end of intervention. The 10 kHz stimulation showed a lower handgrip strength during the intervention (28.1 N, SEM 3.9) when compared to 5 kHz (31.1 N, SEM 3.6; p < 0.001) and to sham stimulation (33.7 N, SEM 3.9; p < 0.001). Furthermore, only stimulation at 10 kHz decreased handgrip strength when compared to baseline.

Conclusions: These findings suggest high-frequency stimulation has an inhibitory effect over muscle strength. Future studies are required in patients that are characterized by motor hyperactive such as spasticity or tremors.

Clinical trial registration: NCT, NCT03169049 . Registered on 30 May 2017.

Keywords: Electric stimulation; Hand strength; High-frequency alternating current; Motor nerve block; Nerve conduction.

Conflict of interest statement

Ethics approval and consent to participate

The local ethical committee of the “Complejo Hospitalario de Toledo” gave approval to the study and warranted its accordance with the Declaration of Helsinki (number 158; 2-11-2017). Written informed consent was obtained from all participants prior to participation.

Consent for publication

Not applicable.

Competing interests

Avendaño-Coy, Taylor and Gómez-Soriano have a patent of a device which evokes electrical current between 10 kHz and 50 kHz, although this device has not used in this work. The remaining authors have no conflicts of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Stimulation effect on maximal handgrip strength. Sham stimulation (circle), 5 kHz (square), and 10 kHz (triangle). Data are represented as mean and standard error. * Indicates significantly different compared to sham stimulation (***p < 0.001; **p < 0.01). + Indicates a significant difference compared to 5 kHz stimulation (++p < 0.01). # Indicates significantly different from baseline (###p < 0.001)

References

    1. Bhadra N, Kilgore KL. High-frequency electrical conduction block of mammalian peripheral motor nerve. Muscle Nerve. 2005;32(6):782–790. doi: 10.1002/mus.20428.
    1. Tai C, Roppolo JR, de Groat WC. Response of external urethral sphincter to high frequency biphasic electrical stimulation of pudendal nerve. J Urol. 2005;174(2):782–786. doi: 10.1097/01.ju.0000164728.25074.36.
    1. Williamson RP, Andrews BJ. Localized electrical nerve blocking. IEEE Trans Biomed Eng. 2005;52(3):362–370. doi: 10.1109/TBME.2004.842790.
    1. Avendano-Coy J, et al. Effect of unmodulated 5-kHz alternating currents versus transcutaneous electrical nerve stimulation on mechanical and thermal pain, tactile threshold, and peripheral nerve conduction: a double-blind, placebo-controlled crossover trial. Arch Phys Med Rehabil. 2017;98(5):888–895. doi: 10.1016/j.apmr.2016.11.020.
    1. Ackermann DM, et al. Electrical conduction block in large nerves: high-frequency current delivery in the nonhuman primate. Muscle Nerve. 2011;43(6):897–899. doi: 10.1002/mus.22037.
    1. Serrano-Munoz D, et al. Intensity matters: therapist-dependent dose of spinal transcutaneous electrical nerve stimulation. PLoS One. 2017;12(12):e0189734. doi: 10.1371/journal.pone.0189734.
    1. Aarskog R, et al. Is mechanical pain threshold after transcutaneous electrical nerve stimulation (TENS) increased locally and unilaterally? A randomized placebo-controlled trial in healthy subjects. Physiother Res Int. 2007;12(4):251–263. doi: 10.1002/pri.384.
    1. Claydon LS, et al. Alternating-frequency TENS effects on experimental pain in healthy human participants: a randomized placebo-controlled trial. Clin J Pain. 2013;29(6):533–539. doi: 10.1097/AJP.0b013e318262330f.
    1. Sisto SA, Dyson-Hudson T. Dynamometry testing in spinal cord injury. J Rehabil Res Dev. 2007;44(1):123–136. doi: 10.1682/JRRD.2005.11.0172.
    1. Beatti A, et al. Penetration and spread of interferential current in cutaneous, subcutaneous and muscle tissues. Physiotherapy. 2011;97(4):319–326. doi: 10.1016/j.physio.2011.01.008.
    1. Yang G, et al. Post-stimulation block of frog sciatic nerve by high-frequency (kHz) biphasic stimulation. Med Biol Eng Comput. 2017;55(4):585–593. doi: 10.1007/s11517-016-1539-0.
    1. Kilgore KL, Bhadra N. Nerve conduction block utilising high-frequency alternating current. Med Biol Eng Comput. 2004;42(3):394–406. doi: 10.1007/BF02344716.
    1. Ackermann DM, et al. Effect of bipolar cuff electrode design on block thresholds in high-frequency electrical neural conduction block. IEEE Trans Neural Syst Rehabil Eng. 2009;17(5):469–477. doi: 10.1109/TNSRE.2009.2034069.
    1. Ackermann DM, et al. Conduction block of peripheral nerve using high-frequency alternating currents delivered through an intrafascicular electrode. Muscle Nerve. 2010;41(1):117–119. doi: 10.1002/mus.21496.

Source: PubMed

Подписаться